High prevalence of systemic autoimmune diseases in patients with Menière's disease.
High prevalence of systemic autoimmune diseases in patients with Menière's disease.
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DOI：
10.1371/journal.pone.0026759
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Lopez-Escamez JA
中科院分区：
文献类型：
--
作者：
Gazquez I;Soto-Varela A;Aran I;Santos S;Batuecas A;Trinidad G;Perez-Garrigues H;Gonzalez-Oller C;Acosta L;Lopez-Escamez JA
自身免疫似乎与梅尼埃病（MD）的病理生理学相关，梅尼埃病是一种内耳疾病，其特征在于与听力损失和耳鸣相关的眩晕发作。然而，在患有单侧或双侧感音神经性听力损失（SNHL）的个体中，尚未研究MD患者自身免疫性疾病（AD）的患病率。我们使用临床标准和免疫检测（淋巴细胞群、抗核抗体、C3、C4和促炎细胞因子TNFα、INFγ）评估了6家三级转诊医院耳神经科门诊690例单侧或双侧SNHL MD患者的AD患病率。观察到的类风湿性关节炎（RA）、系统性红斑狼疮（SLE）和强直性脊柱炎（AS）的患病率高于一般人群的预期（RA为1.39，SLE为0.87，AS为0.70）。系统性AD在MD和偏头痛诊断标准的患者中比MD和紧张型头痛患者更常见（p = 0.007）。 单侧或双侧SNHL患者之间存在临床差异，但免疫特征无差异。多元线性回归分析显示，淋巴细胞亚群的变化与听力损失和眩晕的持续性有关，这表明免疫反应在MD中的作用。尽管存在一些局限性，但MD显示全身性AD如RA、SLE和AS的患病率升高。这一发现，这表明在MD患者的一个子集的自身免疫背景，有重要意义的MD的治疗。
Autoimmunity appears to be associated with the pathophysiology of Meniere's disease (MD), an inner ear disorder characterized by episodes of vertigo associated with hearing loss and tinnitus. However, the prevalence of autoimmune diseases (AD) in patients with MD has not been studied in individuals with uni or bilateral sensorineural hearing loss (SNHL). We estimated the prevalence of AD in 690 outpatients with MD with uni or bilateral SNHL from otoneurology clinics at six tertiary referral hospitals by using clinica criteria and an immune panel (lymphocyte populations, antinuclear antibodies, C3, C4 and proinflammatory cytokines TNFα, INFγ). The observed prevalence of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) was higher than expected for the general population (1.39 for RA, 0.87 for SLE and 0.70 for AS, respectively). Systemic AD were more frequently observed in patients with MD and diagnostic criteria for migraine than cases with MD and tension-type headache (p = 0.007). There were clinical differences between patients with uni or bilateral SNHL, but no differences were found in the immune profile. Multiple linear regression showed that changes in lymphocytes subpopulations were associated with hearing loss and persistence of vertigo, suggesting a role for the immune response in MD. Despite some limitations, MD displays an elevated prevalence of systemic AD such as RA, SLE and AS. This finding, which suggests an autoimmune background in a subset of patients with MD, has important implications for the treatment of MD.
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